Wednesday, 30 December 2015

Midnight and Lows

I wrote about this hypo experience before I got my CGM (Continuous Glucose Monitor) and so these days crashing blood sugars are not coming at me like oncoming trains and I am able to get off the tracks in time.

A few nights ago, I experienced the feeling of watching a "train wreck" coming towards me and not being able to avoid it. The problem, I think, the fact that I had too many options available to me in trying to prevent my imminent hypo that I didn't know which one was best to choose.



Normally, when I check my blood glucose level two hours after my dinner and they are above my post-meal target, I know that some more insulin is required. On this occasion it was 3 hours after dinner and I was even more sure that I needed more insulin. See the 11.5 mmol (207 mg/dl)

HOWEVER! Approximately 60 minutes after I had given myself more insulin, the big red dot and the sharp dip in my mysugr app told me that my diabetes was not playing by the rules!  My blood sugar level had dropped sharply to  6.1 mmol (110 mg/dl). An otherwise respectable BG number but at this moment in time, especially with the remainder of my insulin dose to activate, I knew I was in trouble and that a hypo was coming for me.

I was already tucked up in bed with my teeth brushed. So, I reduced my background insulin by 50% for an hour and a half to counter the over correction of insulin. (Note to self; that wasn't the right choice - always go for the fastest acting glucose available).

At 12:13am, perspiration steamed off me. Thankfully, I had the wherewithal to check my blood sugars again revealing a 3.1 mmol (56 mg/dl). I took 3 dextrose tabs and lay back waiting for them to kick in. But, the heat coming off my body made me grab 2 more a couple of seconds later.

I tried to lay there waiting again but I became more agitated at having to wait.... and wait, and wait, for the heat and sweat and "jitters" to subside. The seconds felt like hours!

I decided to wait the 15 minutes out downstairs and suck on some boiled sweets to, maybe, trick my brain into thinking I was shoveling glucose into me hand over fist and avoid over-treating the hypo. I pulled out the laptop and tried to document this hypo ;-) Another effort to avoid over-treating-keep my hands busy.

12:37am, 5.8mmols (104mg/dl), still feeling shaky and mildly damp but can safely go back to sleep. After brushing teeth.... again.

And yes, I had the over-correction high blood sugar reading the next morning. Sometimes, you just can't win. But you try, and try to learn:-)

Happy New Year from Gráinne

Tuesday, 22 December 2015

I made it through another year with diabetes!!!



May the food be worthy of the bolus,
the alcohol worthy of the hangover,
may that one day not effect my HbA1c level too much and,
may we all be back on top of our diabetes in the new year :-s

Grainne.
See you in 2016.

Thursday, 17 December 2015

I have nothing to fear but fear itself

Image from http://james-the-nose.deviantart.com/art/
A-deer-in-the-headlights-122552318
I attended a diabetes meeting once where one of the other attendees said they wanted to see photos of all the horrible things that can happen to a person with diabetes if they don't take care of themselves. That this would motivate this person into doing more to take care of their diabetes. I understood this person's point of view, they were much older than me and may have seen the "dangers" of diabetes as being more imminent than I did.

For me though "the fear tactic" doesn't work. I've heard all the horror stories. I've heard all of the threats in relation to what I should and what I should not be doing to take care of my type 1 diabetes. And I have been paralysed into doing nothing by them.

I think it's a well known piece of advice that fear is not a good motivator to get somebody to do something. Do you like it when someone threatens you? Even if it's for your own good? Does it make you want do what they say?

For me, it, absolutely, does NOT! But you might ask me what does get me moving and doing? My answer is "Information and inspiration" ;-D

I don't test my blood glucose more because someone told me I should. I do it because it was explained to me why I should consider it and how to use the additional information (EDUCATION, can't. say. it. enough.). And I could see almost straight away how this improved my management of my type 1 diabetes.

I do remember, all those years ago, when I was told that I had to eat a strict "diabetic" diet and I absolutely HAD to take my insulin at exactly the same time every single day. If I didn't I would end up with all sorts of ugly diabetes complications.

But guess what? Some people do all the right things and still get complications. And some people don't take care of themselves and don't get any complications.

Those were the days when we had very little in the way of diabetes research or education to revert to. But by God we had fear! And it got me nowhere!!



What did motivated me to do all the things that I do to take care of my diabetes? Education, education, education and some more education. Can't say it enough times!!! And of course, a good support network:-)


Friday, 11 December 2015

DKA Kills and the Type 1 Diabetes Awareness Project

We don't know how many children or adults die in Ireland because of undiagnosed Type 1 Diabetes but we can be sure that it does happen here, just like it happens all over the world. 

As the news is travelling through the diabetes community of yet another life cut short, I'm awakened, with a jolt, as to why the Type 1 Diabetes Awareness initiative from Diabetes Ireland is so important... And needs to happen soon!

Diabetes Ireland are planning on launching this Type 1 Diabetes Awareness project early in the new year. 

Image graciously stolen from Diabetes Mine
Up to 23 Irish children are diagnosed each month with Type 1 diabetes. The majority of these present to their GP feeling generally unwell but 1 in 8 will not be correctly diagnosed at that time. 

This delay in diagnosis usually means repeated visits to the GP and can result in diabetes ketoacidosis (DKA) which is potentially fatal.

The aim of this project is to encourage GPs to consider Type 1 diabetes first, as a potential diagnosis when a child presents feeling generally unwell and secondly to raise awareness among the general population of Type 1 diabetes signs and symptoms (The 4T's; Toilet, Thirsty, Tired & Thinner).

However, Diabetes Ireland still need to find one quarter of the funding for this project. They are determined to commit to the February 2016 launch date but if they don't find the rest of the money they will have to amend the initiative, which would make it less effective.

Does anyone have a wealthy relative??? 

Image from http://res.public
domainfiles.com/pdf_view/
52/13526046019596.png
Maybe if we start sharing this with our friends and talking about it, the people who hold the purse strings will take notice that this is important to us?


Just in case you're wondering; what is DKA?


" Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead.
When fat breaks down, waste products called ketones build up in the body." Find out more here


Thursday, 10 December 2015

I'm back on CGM (Continous Glucose Monitoring) Yayyy!

Back in June, I did a trial with a CGM (Continuous Glucose Monitor) and I wrote a little about my experience here. Wearing the CGM was so valuable that I was very much determined to get it permanently.

I'm thrilled to say that happened on the 25th November. So I've been using it for two weeks. I had a little hiccup with my pump, which decided to die on the 30th, which made me appreciate the CGM more as it's so helpful the not only know what my blood sugars are but also know where they are going. It was such a relief to see that down arrow.

This time around I feel like I know what I'm doing this time around with this new gadget. The workshop I attended in July presented by author of "Think like a Pancreas", Gary Scheiner entitled "Making Sense of the CGM Data" also helped.

The technology was so new to me in June that I was preoccupied by "how does this thing work?". I was only just getting a handle on having all that extra information by the end of the two weeks. I had been able to upload the information to the software programme and identify trends where I could make some adjustments in my insulin regimen.

But then the trial ended and it was like being blind again.

The major benefit of having a CGM is having this;
This is the graph from my CGM data.

 as opposed to this;


and knowing what to do with all those extra data points.

After two weeks, I have been able to prevent a number of lows by my CGM alerting me to the fact that my BG was 4.4mmol/L and dropping. And I've been able to reduce the impact of how high my blood sugar climbs. It's my hope that this will increase how much time I spend within my target blood sugar range of 4 mmol/L to 10 mmol.L (72 mg/dL to 180 mg/dL) overall.

People who have lived with type 1 diabetes since before the 1970's often talk about how access to blood glucose monitors changed diabetes management in a revolutionary way.

I think that the CGM is a game changer for my generation of type 1 diabetes.

Thursday, 3 December 2015

Insulin Pump Wizardry

I have been using an insulin pump for just over 5 years and I'm still finding new benefits in pump therapy. I should explain that I know I am very much a slooooowwww adapter of all things new - I go at my own pace.

Earlier this year, I started using the EzCarb and the EzBG features on my pump a bit more. Previously, I really only used them for correction insulin doses. I use an Animas Vibe pump and I'm told that on the Medtronic pump this feature is called the Wizard.

Since I've started using this feature I have noticed a reduction in the number of hypos that I have been having.

Before, I had a tendency not to factor in my Insulin on board, I didn't really have a way to calculate it. Insulin on board is the term used to describe how much insulin is left working in your body from the last bolus and how active it is.

Also, I would only factor in a correction amount of insulin if I was over 10 mmols/L (180 mg/dL).

I have to say that since using these features I feel like I have reduced the number of hypos that I have. However, I have nothing to back up my theory, it's just a hunch! But it feels nice.

I also like it because it separates out my insulin dose so that I know how much of my insulin is related to the carbohydrate, how much is a blood glucose correction and how much I have to reduce for my Insulin on Board.

Here's to continually making improvements and to tiny triumphs!

Disclaimer: I have not been paid by anybody in relation to this post. 

Thursday, 26 November 2015

Walk Your Diabetic Feet To The Pathway of Good Foot Care

Our guest speaker at our November diabetes get-together in Co. Clare is a podiatrist from the local health centre (Thank you, Doireann). And I know that most people with diabetes know the basics of taking care of your feet, especially if you have been around diabetes for a couple of decades.

The reason I decided to post about our meeting is that the pathway to podiatry has changed a little in recent years and that is worth sharing this information (IMO).

But I have included an article which, coincidently, was published online this week, and contains some of the basics to lead up to the local information.


So, why do healthcare professionals stress the importance of good foot care?


“In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.” (from International Diabetes Federation). But a simple annual foot check can prevent or reduce your risk of developing serious problems with your feet.

“People with diabetes have special reason to take good care of their feet. High blood glucose levels may make feet susceptible to injury and infection. This is because the protective sensation in the toes or feet – your “pain alarm system” ­may slowly disappear with long term high blood glucose levels.” (from Diabetes Ireland)


The Foot "Issues".


The two feet problems that podiatrists (and people with diabetes) are on the lookout for are;

Nerve Damage

Nerve damage can cause you to lose feeling in your feet. You may not feel pain, heat, or cold in your legs and feet. You may not feel a pebble inside your sock that is causing a sore. You may not feel a blister caused by poorly fitting shoes.

Sores on your feet can become infected. If your blood glucose is high, the extra glucose feeds the infection in those sores and the infection gets worse. Nerve damage can also cause pain and lead to foot deformities, or changes in the muscles, bones, and shape of your feet.

Poor Blood Flow

Poor blood flow means not enough blood flows to your legs and feet through your blood vessels. Poor blood flow makes it hard for a sore or an infection to heal. This problem is called peripheral artery disease, also called PAD.

Sometimes, a bad infection never heals. The infection might cause gangrene. If you have gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

Too much glucose in your blood from diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems.” (from the American National Institute of Diabetes and Digestive and Kidney Diseases)


Everybody with diabetes in Ireland should have a foot check by a podiatrist, children included, every year.

I know that some doctors and consultants might perform a brief foot check at your clinic appointment but our podiatrist (and lots of other reputable websites) state that if your foot check does not include a test using a tuning fork and a Monofilament tool.
Monofilament Tool


At your annual foot exam your healthcare professional will;


  • Look at your feet for signs of problems, especially if you have nerve damage
  • Test the sense of feeling in your feet using a Monofilament tool.
  • Test how well blood is flowing to your legs and feet
  • Show you how to care for your feet


How do access Diabetic Foot Care?


Referrals to your local podiatry service for people with diabetes are available from your GP, Public Health Nurse, Community Nurse, or Diabetes Clinic.

In Co. Clare, you can avail of a self referral form which is available at the Health Centre on Bindon Street in Ennis. It’s not available online. And we believe that this option is only available in Co. Clare.

Your very first foot screening with your podiatrist will assess you and place your feet in one of three categories; Low, Moderate or High risk.

If you are low risk, you may be referred back to your GP’s surgery for your annual foot exam. If this is the case then it will be your responsibility to schedule this. If you are referred to your GP, it’s really important that you keep a record of when your last foot check was and when to schedule your next one.

If you are Moderate or high risk of diabetes foot disease then you will probably continue to be seen in the Diabetic Foot Clinic, where they will send out your appointment to you in the post.

However, there are instances where the clinics fall behind in their appointments and it would be wise if you kept a record of when your last foot exam was and when your next one should be.

You can find more information from the HSE's Model of Care for the Diabetic Foot document, which was revised in October 2014.


Thursday, 19 November 2015

Explaining Type 1 Diabetes to Non Diabetics

I spend a lot of my time "hanging" and communicating with other people with diabetes. I realise that I'm very lucky to have that when I have come across so many people who have never met anyone else with diabetes.

So, when I find myself in a situation where I have to explain type 1 diabetes to someone who is not a member of that community, I actually find it extremely difficult. Even when I know it's coming!

Two such encounters have prompted me to try harder in this and I sat down to considered the following;
- when I want to share my diabetes story where is the best place to start (without turning it into a rambling, never-ending tale)?
- And, how do I connect with people who have no connection to diabetes? How do I explain it so that they ask me good questions?

Here is what I came up with! And I did decide to try to keep it simple and specific to my diabetes, which means I know a lot of you will have lots more to add to it. But this is my starting point.

What is type 1 diabetes?

Type 1 diabetes happened to me when my body, for no apparent reason, decided to destroy the part of me that makes insulin.

What the heck is insulin?

Everybody needs insulin to be able to turn the food they eat, namely carbohydrates, into energy. If I don't have insulin, I will die of malnutrition, even though I eat.

Type 1 diabetes is kindof like an allergy to carbohydrate. I cannot eat carbs without taking insulin. And if I don't take insulin, what the carbs become once I have digested them, the sugar/glucose builds up in my blood and starts to do bad things to my organs.

What if, every time you ate any of these foods you had
stick a needle into yourself?

If I just didn't eat carbohydrate would that not make life easier?

A person without diabetes might respond to this with "What if you just didn't eat carbohydrate would that not make life easier?"

Not really, our liver, also, releases glucose and we can't turn that into fuel either. So, we actually have to take insulin to deal with that sugar/glucose that is being continuously released in the background.

So either way, we need to inject/infuse insulin or we die.

What if you just measure how many carbs you are eating against how much insulin you are taking?

One of the ways people manage their with type 1 diabetes is to measure how much insulin they take and measure how much carbohydrate they eat.

This is where I know I am going to lose you.

Type 1 diabetes is more complex than that. There are other factors that influence blood sugar/glucose (BS). Sure;
  • Food brings BS up, but all foods raise BS differently. 
  • Insulin brings it down.
  • ANY physical activity has the potential to bring it up or down.

But there are things that influence BS that are not easy to measure.
  • Hormones such as adrenaline, the stress hormone cortisol, menstrual hormones can raise or lower your BS. 
  • Illness raises BS.

These are just a few, here's a list of 22 other factors that commonly influence BS.

Living with type 1 diabetes is tracking all of this and more. It's exhausting!


So all I need now is a guinea pig volunteer to try it out on? Oh and here's some more helpful tips to help explain type 1 diabetes to people.


Thursday, 12 November 2015

The HbA1c and how does it fit into Diabetes Management.

Our HbA1c is just one piece of information in the picture of our diabetes management.

It is really important to our healthcare providers because that's how they measure how well THEY are doing in keeping people with diabetes healthy. It's a global measurement and so they can use it to compare their service to services in other countries.

For us, the individual with diabetes, it really doesn't have that much value. You might feel differently but for me, it's just another number, one of many that I use to manage my type 1 diabetes.

I have had a good HbA1c for a number of years now. But there was a period of time a couple of years ago when I had an excellent HbA1c of 48 mmol/mol (6.5% NGSP unit). However, both myself and my endo were confused because my blood glucose readings told a very different story. They were ALL OVER THE SHOP!!! Not one of my BG readings was within any of my targets!

They were so bad that while my meter was counting down from 5, I would close my eyes tight, cross my fingers and hope for a single digit, as in less than 10
mmols.

We figured out that I was having more than the occasional hypo during the night and not waking up (Flipping scary). These lows were offsetting the highs during the day, making my HbA1c appear excellent.

These days, I look up my average blood glucose reading over 30 and 90 days on my meter. Plus, I look at my "standard deviation". The Standard Deviation SD is a measure of how spread out my numbers are and it's measured in a percentage. 

"Say your average blood glucose reading is made up from a 13.9mmol (250mg/dl) and a 2.8mmol (50mg/dl) giving you an average of 8.3mmol (150mg/dl). The 8.3mmol (150mg/dl) average is not bad, but the 2.8mmol (50mg/dl) is too low and the 13.9mmol (250mg/dl) is too high. So if you only look at the average, you might think you are doing well, when in fact you are not doing so well.Source; Diabetes Daily

The SD from the example above is +/-7 which is quite a spread.

Ultimately, I want to smooth out the peaks and troughs of my blood sugars and that's why I would like my average blood glucose reading to be between 8 and 9 mmols and my standard deviation to be a small as possible.

I was always tempted to brag a little about having reasonable HbA1c results. But once I learned about SD it removed all temptation.

Thursday, 5 November 2015

Diabetes Interruptus

Let me count the ways that diabetes interrupt my life.

Wednesday evening I attended a business women's network event. I know I eventually have to leave my career of stay at home mother because, well, they grow up, don't they! So I'm trying to get my head around the fact that I NEED to go back to work in the next year or two!!!

Anyway, half way through this event we had a much valued break where we could, you know, network. We had moved around the room and I had left my bag at another table. Once I assessed that the finger food was worthy of insulin and filled my plate, a very nice lady started a conversation as I was filling my cup with tea. I had to excuse myself to return to my bag because I needed to test my blood sugars and work out a SWAG (Scientific, Wild Assed Guess Bolus).

When I'd finished she was surrounded by 4 others ladies, clearly, she was a person that I would have liked the opportunity to talk to. But the opportunity was lost because of my diabetes.

Thursday evening, I over estimated my carb count at dinner and about one hour after dinner I began to descend into a low when my phone rang. I didn't recognise the number but I still had a hard time deciding that I should not answer it and deal with my hypo instead.

Turns out it was the Mum of one of my children's new friends wanting to arrange a play date. I didn't get to call her back for a couple of days.

I try to make sure that diabetes doesn't interrupt our family life or my life by planning ahead as much as possible.

But sometimes, it just doesn't work.


Thursday, 29 October 2015

The Big Blue Test for World Diabetes Day



This year, for World Diabetes Day, I am piggy backing on someone else's idea and taking part in the Big Blue Test.

Why?

Because it's simple, it's easy, it doesn't cost me anything to participate, and it's giving to those who don't have access to insulin. Hell, it's just a good idea and I'm hoping that some of you will think so too and join me?

What is the Big Blue Test BBT?


The Big Blue Test is a diabetes awareness initiative that was started 7 years ago by an American non-profit organisation, called the Diabetes Hands Foundation (amazing organization worthy of another post). The BBT is about how one small change can have a huge impact on your health; if you have diabetes or not.

And every BBT logged raises money for those with diabetes who are less fortunate than us.

Results gathered over the lifetime of the program demonstrate that just 14 minutes of exercise has the potential to decrease participants’ blood glucose levels, in some instances as much as 20% (Type 1's should pack a Snickers;-D).
Not only is The Big Blue Test encouraging people who don't have diabetes to exercise and creating awareness about diabetes, but it's creating awareness in our own community about how effective even a little bit of exercise is as a diabetes management tool.

And, by participating in the Big Blue Test, we get to help people living with diabetes who are in need with grants for life-saving diabetes supplies, treatments and patient education, usually in developing countries.


How do I take the test?


Taking the Big Blue Test is easy:

  1. If you have diabetes you test their blood sugar, if you don't have diabetes, don't check your blood sugar.
  2. You exercise for at least 14-20 minutes.
  3. You test again (if you have diabetes), and
  4. You share their experience on BigBlueTest.org or through the app for iPhone or Android.

Log in, take the test. Do a little good today for yourself – and someone else.

From Diabetes Mine



Thursday, 22 October 2015

What happens after MasterLab Advocacy Conference?


And thank you to Christelle Aprigliano from MyPerfectD, who inspired me to write this post in gratitude for being chosen as a scholarship winner to attend MasterLab last July.

The timing of which is significant because we just had our very first Thriveabetes conference in Ireland.

Before I go into what happened after MasterLab, let me first explain where I was before I attended.

I had an idea, that we, in Ireland, were entitled to experience the type of conference that people with diabetes in the UK and the US we're enjoying. A peer support conference. Turns out some other people had that same idea too. So, we came up with a plan, raised some money and were busy executing that plan to make Thriveabetes happen. And everything was going to plan.

However, until MasterLab I was wandering around aimlessly on the diabetes advocacy path. I really didn't know what I was doing or how to verbalise what I wanted to do.

On the very first morning of ML, we did the all-important ice breaker and introductions. I took a deep breath and tried to figure out why I was there in my head before it was my turn.

I introduced myself with "Hello, I'm Grainne, I'm from....", followed by my volunteer bit and then, added that really, the main reason I was there was to learn if I could organise Thriveabetes better. The response I got was that I should lead with the bit I ended with:-S Lesson #1 learned.

From that moment on, I was one of the organisers of Thriveabetes and I realised that every moment since 2007, when I helped set up our local diabetes support group, was leading up to this.

Every time I introduced myself I did it a little bit better and with more confidence. Without meaning to, I networked! But for me, it was an opportunity to meet the most interesting people and hear their diabetes stories; networking never seemed so easy! I had more Facebook friend requests in that week, than I had since I set up my Facebook profile.

At ML, I realised that I had found a path I wanted to travel, that I had been on that path; rambling unintentionally, for a long time. I found focus and I found my purpose.

Little did I know that in 2007 when I was at my lowest. I had been struggling to find decent diabetes healthcare for 18 months and I had just had a clinic visit where I sat in a Digital Chair Weighing Scales, used in nursing homes, retirement homes and rehabilitation centres.

I was desperate to find decent health care and I was desperate to find other people with type 1 diabetes to share with. That's when I set about starting our support group.

At the Thriveabetes Conference, we found that sense of community, of strength. We have found a way to connect with each other and a way to help each other.


Today, we are planning Thriveabetes 2016!

   

Tuesday, 13 October 2015

Would you like to volunteer abroad and help people with diabetes?

I came across this group at a diabetes conference and not only do they have an interesting story but they also offer people with diabetes an interesting opportunity to volunteer abroad with people with diabetes.

I've checked with the organisation and they have said that you do not need to be living in the US to volunteer and in the past people from Ireland have volunteered with them. :-)

They are called AYUDA; American Youth Understanding Diabetes Abroad. The organisation was created in 1996, by two teenagers, Nick Cuttriss and his friend Jesse Fuchs-Simon. They were 14, when they met José Gabriel, an eight year old boy who lived in Quito, Ecuador.

José Gabriel, was six-months-old when he was diagnosed with type 1 diabetes in 1984. Eight years later, despite spending most of the family's income on his diabetes supplies, José's parents saw his health decline again. In an effort to understand what had gone wrong, José's family raised money for him to travel to see a diabetes specialist.

They discovered José and his parents had never received guidance regarding the management of the boy's condition and that José's blood sugar levels were not being managed correctly. For José and his parents, and for many other young people with diabetes, particularly in developing countries, the lack of diabetes education is as dangerous as a lack of insulin.

Nick and Jesse envisioned a youth-led organization that would educate young people with diabetes about diabetes issues, and help empower them to work effectively for positive change.

AYUDA's initial objective was to help with the need for basic diabetes education in Ecuador.Volunteers set up diabetes support groups in the corridors of a public hospital in Quito. These groups offered educational workshops and provided a forum for knowledge sharing. 

Since 1996, they have also recognised that the cost of diabetes supplies was making it impossible for many children in developing countries to manage their condition optimally and so they set about creating and managing diabetes supply banks. It costs approximately 3000 USD per year to care for a child with diabetes; the average income for a family of four in many Latin American countries is less than 1000 USD per year.

With the help of partners such as Insulin for Life, AYUDA works to ensure that families with limited resources receive essential daily supplies, such as insulin, syringes, and test strips at subsidized prices or free of charge. 

For more information on AYUDA and volunteering opportunities, visit the website at www.ayudainc.net or email info@ayudainc.net. They are now accepting applications for their 2016 projects in the Dominican Republic.

Thursday, 8 October 2015

Diabetes Mother need support not hate!

I've just written a letter to the Editor of the Irish Times in response to the public reaction to the article linked below. I can't stop thinking about this woman and here's why;

"Sir,

I read "Diabetic girl must be given insulin despite mother’s stance" (2nd October) late last night and I thought about this woman going to bed. I awakened early and she was the first thought that entered my head.

Isn't it conceivable that this woman is so desperate, so exhausted and so depleted of hope that there could be any positive outcome from a type 1 diabetes diagnosis that it has rendered her paralyzed to help herself or her daughter?  Isn't it conceivable that while she "knew very well the importance of insulin" her personal experiences have coloured her view of insulin to the point of apparent ignorance?

Maybe we should see this woman as somebody who needs support and is every bit as much of a patient affected by type 1 diabetes as her daughter is.  Studies have shown that the more supported and informed a mother feels the better the outcomes of the child with type 1 diabetes. It seems to me that this woman is in desperate need of support - peer, emotional, and psychological.

I'm asking the Irish type 1 diabetes community to do what I know you do best. I'm asking you to reach out to a fellow parent at their time of diagnosis. Do you remember what you needed at that time? Can we offer that help to her?

Lets offer her shoulders to cry on, offer to stand with her shoulder to shoulder, holding her up and guiding towards hope for a better future for her daughter. Let's share our diabetes stories with her and show her it's possible.  Lets share our challenges and triumphs of living with type 1 diabetes.  Let's tell her that we know living with type 1 diabetes is difficult and sometimes unbearable but that it's not always like that.

Lets not shame her because we ALL know that shaming and blaming does NOT accomplish anything, especially in life with type 1 diabetes.

Sincerely,
Gráinne Flynn"

Friday, 2 October 2015

I'm M.I.A.

Not really! But you can find me over here at Thrive-abetes.

Monday, 14 September 2015

New Diabetes Products I came across at FFL 2015

The exhibit hall was huge at the Friends for Life (FFL) 2015 conference. I wrote a little about the whole FFL experience a couple of weeks ago which you can read about here.

While wandering, meeting people and talking to the company representives, I came across a couple of products I had not seen before. In the interest of sharing with people in Ireland I thought I would document them.

One of the last items I came across but one I have actually used since I got it is;

A Pump Key.

A wha, you ask! Well, this is a multi-purpose tool, but it is specifically designed to open the battery compartment of your insulin pump, instead of using a 5c coin, so you can replace your pump's battery.

Now fancy that!

I say that it's multi-purpose because it helped free my daughter from being locked into a hotel bathroom.

She also said that it was the most adorable thing she has ever seen!

It's available from Cute Diabetes Nik Naks. The Pump Keys cost $20.00 Australian Dollars (€13) and shipping to Ireland costs are $2.75 - $10.00, that's Australian Dollars, depending how many products are ordered. 

BD AutoShield™ Duo Pen Needle

This is another smart idea. I have stabbed myself with my needles a couple of times and it's usually a bloody mess. Those things are sharp and create a lot of blood when used accidentally.

So a shielded needle for insulin pens, to me, sounds like a great idea. Here's a video on how it works.

The BD AutoSheild Duo is available in Ireland. However, it is not available through the GMS (General Medical Services Scheme (GMS - medical cards) but I understand patients have been able to seek LTI (Long Term Illness) cover under compassionate grounds.

It's worth noting that BD also make a device that clips the needle off your insulin pen needle for safe disposal. This device is called the BD Safe-Clip, as well as many other items we use for diabetes. I also noticed that my lancet devices that comes with my One Touch Verio IQ blood glucose meter is made by BD!


I also came across stickers for your Insulin Pens from Lilly and stickers from Pump Peelz for Insulin Pumps.

Saturday, 29 August 2015

Diabetes complications are real! Let's talk about it.

What would happen to me if I had to face one of my biggest fears? I'm absolutely petrified of diabetes complications.

I used to think that if I lost my sight and could not see my children anymore that it would be the last straw for me. I would imagine finding it very difficult to find a way to "power through".

But meeting Kimberly Hislop taught me that I would probably face it like I do my diabetes-head on.

I met Kimberly at the MasterLab Diabetes Advocacy conference in July, where she touched so many lives. She is a powerful advocate for diabetes and I'm sharing her guest post on SixUntilMe because her message should be shared.

Diabetes complications are real. I think because soooo many people tell us about their relatives who've lost limbs to diabetes, that in an act of rebellion, we overcompensate with positivity. This makes people with complications feel like they're letting the side down. But the truth is, diabetes complications do happen, and we need to talk about them!

Terrible photography! Myself & Kim.
Thanks Kim for your bravery and starting the conversation!


Tuesday, 18 August 2015

SeaPeptide Adventures; for People w/Diabetes who want to do amazingly adventurous things!

I was very fortunate to attend the MasterLab for Diabetes Advocates Conference 2015 on a scholarship from the Diabetes Hands Foundation. I was also fortunate to have someone nice to share a room with, who was also a scholarship winner.

I had advance warning of who my room mate was going to be - enough warning to googled her. I love Google but this was one of the few instances where google let me down. 


All I found on Erin Spinetto, was that in 2014, she led the Sea Peptide Swimmers, the first ever all type 1 diabetic team to complete the 12.5-mile Swim Around Key West and In 2011, she sailed solo 100 miles down the Florida Keys after doctors told her I couldn't sail alone with diabetes. This was a significant achievement!

That was only the tip of the iceberg. Upon our brief "Hi, I'm ....." I realised that this lady is a serious adventurer, sporty type! The complete opposite of me the dowdy housewife.

But we did have a lot in common - our passion for living well, actually, thriving with type 1 diabetes.

She had just come directly from North Carolina where the lead a team of Stand Up Paddle Boarders on a 100 mile paddle!!! I feel so fortunate that she was able to hold a conversation with me.

Erin lives in San Diego, California, is married with two children. She is a science teacher and, as we mentioned, an adventurer.



She is also an author! In January 2013, she published her book "Islands and Insulin", where she chronicles her solo sailing adventures and the ups and downs of life as a diabetic. In Islands and Insulin, Erin sails a 22 foot sailboat down the Florida Keys as she fights winds, currents and swells that threaten to capsize the boat.

What Erin is doing now? She has founded the Sea Peptide Adventure Academy
a home for people with diabetes who are doing, or want to do, amazingly adventurous things.

Sea Peptide Adventure Academy runs an 8-week email based training program that shows you, step-by-step, how to choose, plan, and execute an adventure and how to use adventure to alleviate the stress of a chronic disease like diabetes.

If you would like to find out more about Erin and Sea Peptide Adventures, she explains in this live interview by the Diabetes Hands Foundation. 


Tuesday, 11 August 2015

Will my Daughter Resent my Diabetes?

Last November, I had the privilege of presenting Managing Your Family and Your Diabetes for Diabetes Ireland's National Diabetes Conference.

If the event that I am about to describe had happened before I gave that talk, I think it would have been a very different talk. My daughter and myself had a clash of needs that prompted me to wonder how our relationship would take the combination of my diabetes and her teen years.

My daughter is 11 and is my eldest and therefore "breaks me in as a parent". She is a Tween! Deep breath!

While we were on holidays, actually, we were heading home the next day, so maybe we were ready to be home and approximately 16 hours travelling stood in our way?

We went shopping in the Mall of America, THE largest shopping mall in America. So large it has an amusement park in the middle.

We had to go shopping as we absolutely had to buy formal shoes for my daughter who has a large foot for her 11 years and living on the west coast of Ireland doesn't give you the variety and options that a large, child's foot, or her mother would like.

*Note to self never leave shopping until the end of a holiday!

The afternoon was not going well. We had said good bye to the lake and to our family. We were tired from all the activities during our holiday and we were a little sad.

However, we had successfully chosen her shoes and she wanted to look at sandals next which I deemed, in my own head, a purchase of opportunity and not of necessity. I needed a new pair of runners.

I was feeling tired though, so I intended to zoom around quickly. Feeling tired might also mean that maybe I was having a hypo?  My daughter came up to me and said "I don't know where Dad is", I suggested that she sit in the comfy armchairs while she waited for me.

She came up to me again and I really don't know what transpired next thing I know, she's sitting on the ground at the end of the aisle, scowling and about to cry.

I remember thinking; She needs me but I can't help her right now I need to help myself. I sat too. I ate a pear while sitting, to be safe. I needed help! Call for back up! No answer. Eat while thinking. Stand up for inspiration. There's back up - call out to him.

It was the first time I felt her needs conflicted with mine. It doesn't matter much if a small baby has to wait a minute or two for their next feed while you test blood glucose levels. You can kind-of plan for it. But, how can I plan for unexpected, unpredictable tween outbursts.

I realised that she is at the age now where she will start to realise that my diabetes has an impact on her. Will she resent me for it? I hope not!


Tuesday, 4 August 2015

Diabetes Friends for Life & MasterLab

In July, I was in a hotel resort. In Diabetes World, surrounded by thousands of people with diabetes, and at the Friends for Life 2015 Diabetes Conference. I felt like I was in a dream!

Those of you who have been following my blog for more than a year will know that I attended FFL UK last August and wrote about it for weeks. If you haven't seen those posts, here is the first one. Well, FFL US has given me enough material to write for months maybe even a year!

What is Friends for Life (FFL)?

The FFL conferences are organised by ChildrenwithDiabetes, an American non-profit organization dedicated to providing education and support to families living with type 1 diabetes. 

www.childrenwithdiabetes.com (CWD) was started by Jeff Hitchcock in 1995 in response to his daughter Marissa's diabetes diagnosis at the age of two. The idea was -- and continues to be -- to share experiences with other families, so that together, we can all make a difference in the lives of everyone living with type 1 diabetes.

In August 1999, a diabetes Mom on the CWD email list, Laura Billetdeaux, was planning her family holiday in Orlando in June 2000. She sent out an email to her friends on CWD asking if anyone was interested in meeting up there? 550 people from across the US showed up!

That was the first FFL! And FFL 2015 was their 66th conference to date.

Some FFL 2015 Facts.


- There were over 2,000 families, attending FFL 2015! That number, in itself is impressive, but when you consider how many people make up family then it's mind blowing!

- Anybody who is anybody in the world of diabetes attends this conference. Such as;
  • Gary Scheiner, author of "Think like a Pancreas"
  • Moira McCarthy, Diabetes Mom, Advocate, Autor of “Raising Teens With Diabetes: A Parent Survival Guide” 
  • Charles Kimble, professional race car driver and is the first licensed driver with diabetes in the history of INDYCAR. http://www.charliekimball.com/biography

to name but a few....

- It is huge. So big, some of the booths have play areas for the kids.
- They have childcare facilities, all ages of children programmes, tween and teen programmes, so that ALL of the grown-ups can fully experience the presentations.


They next FFL that might be of interest to folks is in London - however, this conference is sold out since last March.

But if you were planning your 2016 family holiday in America then why consider making the FFL 2016 conference part of your holiday in July? It's MORE than worth it!

I put together some of my photos from both of the conferences I attended in Orlando if you would like a better taste.

"Diabetes Hands Foundation, through the Diabetes Advocates program, covered the costs of my travel, registration and lodging while at MasterLab through a scholarship. That being said, the views and opinions expressed are my own


Tuesday, 28 July 2015

Surviving Jet Lag with Type 1 Diabetes

Living with type 1 diabetes is annoying enough but when you add jet lag on top of it - I just want to curl up in a ball somewhere and sleep. And that won't help in the least!

Myself and my family travelled to Northern Minnesota in America to holiday with family. I always find the jet lag travelling west easier to manage. We had travelled 22 hours to get to our destination. We arrived very late at night and so fell into bed.

I, usually, fall asleep immediately because of absolute exhaustion and I feel that with some sleep already in the sleep bank the crazy early morning isn't so bad. I do my best to stay awake all day and only give in again to the exhaustion at a reasonable bedtime hour.

It takes maybe 3 to 4 days for me to transition from waking at 4am in my US time zone to 8am. Done!

Thanks to SkyPro for image.
However, travelling east to get home proves more difficult.

Usually, my travelling east jet lag doesn't kick in until the second night home. The first night home, I fall into bed early and passed out. Again exhaustion prevails because I've had 2 hours uncomfortable sleep the previous night on the airplane.

The second night, I go to bed as normal, maybe even a little later because I know I'm going to have trouble getting to sleep. It's more frustrating because I'm just becoming more and more tired but unable to fall asleep. Eventually, at 2 or 3 am I will fall asleep but awake not fully rested the next morning. My feet will drag most of the day, and for every day that this continues.

On this occasion, though, I'm up drafting this post at 3am on the first night I have arrive home from said holiday. I did fall into bed at 10pm and pass out.

However, my son was woken up at midnight because a new toy with an alarm was continuously beeping and came into our room for help! I had deposited two hours in the sleep bank and now my body was starving for it's Minnesotan dinner because that's what time it was there. I can't get back to sleep. I was so looking forward to feeling somewhat human tomorrow and to be able to put sentences together again.

It's probably going to take about a week to work the travelling east jet lag off. It's frustrating because I know that lack of sleep has an effect on my blood glucose numbers. It also has an effect on my ability to resist temptation.

Addendum: Sure enough, my blood sugars have been crazy numbers for the past few days. My body is so confused; it obviously thinks I should be sleeping when I'm eating!! And I can't make any adjustments because I don't know when my internal body clock will WAKE UP and get with the Atlantic programme.

Sleep where are you?

Tuesday, 21 July 2015

The Little Purse

I know this is a first world problem but I wanted to mention it.

My mother in law is THE best mother in law in the whole world, she buys me flowers for mother's day every year! And I love that she does that.

She visited us in Ireland last April from Vietnam (in a nutshell, she is splitting the next two years between Vietnam and America, waiting patiently for my father in law to retire). And as you do when visiting from an exotic country, you bring presents.

She brought a collection of lovely items which were to be passed along to my family members if I didn't think I would use them.

I try to be the opposite of a pack rat because I like to leave room in my house for people and not fill it with lots of stuff that I never use.

I had passed on three items at this point, and we came to a lovely, hand made, perfectly sized zip purse, big enough to fit a phone, keys and a little loose cash. I've seen these purses and in fact my mother in law uses one regularly.

She didn't understand how I didn't use one! Of course it has taken me several months to figure out why it is I've never used one. Although, you probably figured it straight away?? Especially if you are a woman with type 1 diabetes.

I do however, just grab my keys, stick my phone in my pocket and carry my blood glucose meter in my hand when I do the school runs.

I'm a different species; the kind that needs to grab my blood glucose meter and glucose in addition to the phone, keys and cash. At that point, I might as well go the whole hog and bring a bag!
This tote was a freebie from the Friends For Life 2015 conference I recently attended. I was reluctant to take it at first because it's a very bright yellow but my "Loot" forced me to take it. It is a great bag - no matter how much I put into it, it never felt heavy! It has been tested:-D
This is for you Kim Hislop! 


Tuesday, 14 July 2015

Diabetes safety is......

​having a spare blood glucose meter.

Blood glucose meters are machines. Machines sometimes fail. What is your back up plan if your meter fails? Do you have a back up plan?

My two decades with diabetes has taught me not to rely completely on one gadget. I have a meter that I like to use most of the time, I have a meter that fits in my pocket when I'm just running out for school pick ups, I have a meter that I keep in the bedroom and I have a spare.

Probably not the best idea that they are all from the same company but three out of the four of them use the same strips and so makes life that little bit easier. And I do have a separate ketone meter that can be used for blood glucose.

So, I don't ever have strip waste and I have loads of options when it comes to blood glucose testing.... and no excuses😟

Tuesday, 7 July 2015

Register today for Thrive-abetes; The Thrive with Type 1 Diabetes Conference




I'm hoping that, by now, a lot of you have heard about Thrive-abetes? Thrive-abetes is a conference that I am, up to my neck, involved with. And it's very exciting! I can't wait to be in a room with 100 other adults with type 1 diabetes!!!

What is Thrive-abetes?

Thrive-abetes ; The Thrive with Type 1 Diabetes Conference and Exhibition is a one day conference for parents of children with diabetes and for adults living with type 1 diabetes. It takes place in Maynooth, Co. Kildare on Saturday the 3rd October 2015.

What is Thrive-abetes going to offer?

"Thrive-abetes" is a first-of-it's-kind event in Ireland - a conference organised by people with type 1 diabetes for people with type 1 diabetes!

This Type 1 Diabetes conference is going to focus on the psychological impact of living with a chronic, lifelong illness. We aim to provide “Inspiration, Motivation and Information” to people living with type 1 diabetes, both parents of children with diabetes and adults, at our conference.

Our speakers include internationally renowned diabetes healthcare professionals, living with type 1 diabetes and nationally recognised diabetes healthcare professionals.

View our conference programme here.

Conference tickets cost €35 per person, or €60 for two tickets. Registration is open through this link https://thrive-abetes.eventbrite.ie. Lunch and refreshments will be provided to all delegates. More details about the Thrive-abetes schedule is available from http://thrive-abetes.blogspot.ie/ or by sending an email to thriveabetes@gmail.com.

If you are interested in making a weekend of it The Glenroyal Hotel has a discounted rate for all Thrive-abetes Delegates plus a number of rooms blocked off for the conference. When you are booking you must quote Delegates Reservation No 172691. interested Room rates are available here.

Tuesday, 30 June 2015

Continuous Glucose Monitoring - my second week


My first week with my CGM was very much in awe of it - my second week was about using the information to reign in my diabetes management.

People get anywhere between seven to fourteen days out of a continuous glucose sensor. I was lucky enough to get reach over 14 days.

In my second week, I started to look at the data in detail and find trends. I downloaded the data from my insulin pump to the Animas software programme, Diasend. With this software I can create reports that tell me what my average blood glucose readings were at each time of the day for any time period I choose.

In particular, I wanted to address my night time basal insulin rates and the fact that it bounced up and down like a rubber ball from 10:30pm til 4am. I selected my date as Monday through to Friday. From the report created, it looked like my evening basal rates were too low and my dawn phenomenon cover was too high.


I made the adjustments and have had a couple of hypos, so I still need to tweak my rates. However, my one and only sensor, because I had it on trial, had bitten the dust and I now feel like I'm flying blind.

I really miss having the extra information to make daily decisions about my insulin dose. The CGM not only gives you an indication of what your blood sugar is, it also indicates, with an arrow, in which direction it is heading. Or a double arrow if it's going there quickly!

This information is soooo useful especially at bedtime. A blood sugar reading of 6.8 mmol/L(122 mg/dl)and holding is much better than 6.8 and dropping.

I hope to apply to the HSE long term illness scheme for funding for a CGM but with holidays and a family wedding it will be, at least, September before I knuckle down to that. 

Tuesday, 23 June 2015

Are you a bad diabetic?

Take a deep breath everybody! I can just picture the steam coming from all of your ears, but let me tell you that in this instance, where I was asked this question, the only purpose it would serve would be to accelerate global warming!

I have never been asked this question before in all of my 22 years living with type 1 diabetes and it really caught me off guard.

Firstly, the person who asked had a number of alcoholic beverages taken so any worthwhile, educational response from me was going to be a complete waste of time! So frustrating!!

Secondly, this person was a very young, public health nurse! ($%^@*#%!!!) A little more frustrating.

How did I respond? Well! I first made faces as if I had swallowed a wasp while my brain tried to figure out how to respond. I think I may have scared her and she would have run away if she wasn't trapped on a bus with me.

I was trying to figure out if she meant if I was a bad diabetic because I didn't manage my diabetes well? Or bad because I had the "worst" kind of diabetes?

So after I made my faces, I said "I don't understand the question?" She probably thought I was the dope:-) Then, she asked if I was a insulin dependant diabetic? Now we're starting to make sense... just not enough for me to invest my time with her on this occasion.

At some point, I will sit down with this child and explain some diabetes etiquette and a few other pieces of information about diabetes.

For now, I will give her the benefit of the doubt and assume that she knows a little more about diabetes that alcohol would allow her to express.

Keep calm, they're only words!

Tuesday, 16 June 2015

My CGMS Awesomeness! My First week.

Disclaimer: I am not a scientist, nor do I have anything close to a medical degree. The views and opinions expressed are my own interpretation of the information and training I have received with my diabetes over 20+ years.


What is a CGMS?

CGMS is Continuous Glucose Monitoring Sensor. It consists of a sensor pod, which contains a very thin needle-like component inserted under the skin. It's about an inch long, the width of two strands of hair and just as flexible. The sensor reads how much glucose there is in the liquid between the cells called interstitial fluid. And it take this reading every few minutes.


This is the glucose sensor with
the transmitter attached.
The CGM has a transmitter attached to the sensor pod which sends the data from the sensor to the receiver. In my case, the receiver is built into my Animas Vibe insulin pump.

A finger pricker blood glucose test on a Blood Glucose Meter measures the amount of glucose in a drop of blood.

It has taken a decade (or two) for the technology in a CGM sensor to match the accuracy of a Blood Glucose meter but in my opinion it was worth the wait.

The Awesomeness!

I can press one button on my pump and have an indication of where my blood sugar is.

I was driving to visit my Mother who lives an hours and a half away - I tested before leaving and I was fine to drive but my CGM alarm went off about 45 minutes into the drive alerting me that my BS were less than 4.4. There were 4.1 and dropping and as the saying goes "don't drive under 5". I wouldn't have caught that low until I was well into it.

A couple of days into sensing, I figured out how to view the 6, 12 and 24 hour graphs. I was so surprised to see that my overnight blood glucose readings are not AT ALL like what I thought they were!

I have done basal rate testing occasionally but was never surprised at the results. I go to bed in range and wake up in range but according to the CGM data there is a LOT of bouncing in between! I had been catching the in range readings every two hours. But in between those two hours was an up-swing. I never would have suspect that.

Whoa!
My sisters hen night was two days into wearing the CGM. So with a couple of beers in my system (and only a couple), and a restaurant meal the predictable happened. My CGM alarmed every 30 minutes to remind me that my blood sugars were in the high teens. But it told me if they were still rising or if there were holding steady which meant that I had more information to address the highs (or high, as it was one long continuous high).

The Meeh!

So, I'd been wearing the CGM on my upper arm for a few days and apart from hitting off a couple of doors I had no huge problems. Just one minor issue, my arm where the sensor is placed is a little tender. So, if I get lucky enough, to be able to use this device again, I would explore other areas to place it.

The layers of tape trying to keep it secure are getting a bit itchy.

My one big concern, at this moment, is that the weather has gotten warmer (finally) and the CGM is visible if I wear a short sleeved t-shirt. I wore a light cardigan over my T the first day. The CGM makes my diabetes visible and I know it's going to be difficult to explain this device when I'm still learning about it myself. But I shall embrace this when I'm ready.


Overall, having the extra information from the CGM is great - I can't deny that. I would love to have one permanently. However, and this is an important however, I would never rely on it explicitly as what my blood sugar reading is. I still do my 8 finger pricker tests daily.